Well, I watched SiCKO and agree with much of what others have said, i.e., Michael Moore has once more succeeded in taking a very complex and serious topic and shown us another perspective on this "best of all possible worlds." As usual, he was warm and sometimes humorous, very down-to-earth, funky, and, of course, biased. This is not to say that there are substantive questions in his reporting, merely that he made no attempt to be impartial or balanced. If his intentions are to incite change, he might actually succeed better with this film than Fahrenheit 911 because, if anything, this one is hotter. Moreover, aside from those who have personal reasons for disagreeing, such as politicians on the take and rich capitalists, there are fewer conflicting viewpoints in this film than some of his others. Therefore, I think his name is guaranteed a place in history.
However, the problems are immense and much, much larger than the picture he did portray. My comments are therefore going to be rather on the personal side because I feel my exposure to the healthcare world is much larger than his. Starting in early childhood, I began to hear stories of socialized medicine in Great Britain and Sweden. At age 9, I went to Sweden and have spent the last 55 years traveling. I have sometimes quipped that with a Sagittarius Moon in the 9th house, my suitcase is always packed. Obviously, this is not literally true, but my point is that I have been in the a position to observe the good and the bad as well as the humane and compassionate and tragic.
At the moment, the U.S. is rapidly losing its status as a developed country. The middle class is being eroded and there is simply massive poverty. Worse, the division of wealth between the rich and the poor is almost unbelievable. To the extent that the rich have a sense of entitlement, they are evidencing almost no sense of responsibility towards those they exploit. This problem was well documented in SiCKO. The fact is there are people in the U.S. whose plights are no better than beggars on the streets of Calcutta, and this is a national shame, greater than the post-Katrina debacle because we have known about the problem a long time and done almost nothing.
The truth is that most people in this country who are destitute now were at one time better off, and this is the major difference between this side of the Atlantic and the other, not to mention third world countries and the U.S. In the years since World War II, the middle class in Europe has become very comfortable and there is practically no poverty in Western Europe. So, we are moving the opposite direction and we are doing so by allowing inequities, inhumanity, and dare we say injustice to prevail.
It is one thing if a country like India fails to provide for all its people, another if we fail. Moreover, as Moore showed in his film, Cuba is handling its healthcare much more humanely. It is actually an exporter of healthcare and thus much to be commended for its success in this realm. Some of you may remember a piece on 60 Minutes about 15 years ago about research on shark cartilade in Cuba. This is really the crux of the problem not covered in SiCKO. In a system that is not beholden to capitalism, there is much more room for innovation. So, while individual patients are neither bankrupted by treatment much less denied coverage, the treatments offered in Europe are still "standard."
I do not know exactly how all the various healthcare systems work in different countries, but I have a fairly good understanding of the German system and somewhat less detailed knowledge of half a dozen other systems. Insurance is compulsory, even for foreign residents, in most countries I have researched. In these same countries, there is a minimum requirement and then additional coverage that can be purchased. Even if one is unemployed, a student, or interested in spending one's money in another way, that option does not exist.
Now, let's take mercury amalgams, something that is controversial in this country. In some states, dentists who remove amalgams for other than cosmetic reasons can be sent to jail, but in California, the dental board was dissolved and laws were passed making it harder and harder to use amalgams. Dentists were trained in how to use amalgams so special training is required to learn how to work with other restoration materials. Some dentists object to this, but many patients have learned that their health requires removal of the amalgams. In Germany, the government paid for this, something that could easily cost someone in this country $12,000 or more, depending on how many teeth need to be redone and what materials are used.
This is quite extraordinary and many people would be ecstatic if such work were covered here, but the insurance companies would maintain "preexisting condition," "lack of scientific evidence that it is necessary," or "not covered by this policy." If all the big, bad insurance companies were replaced by government substitutes, we would have graft, incompetence, low morale, missing funds, fraudulent claims, and the same arguments over the scientific rationale for keeping the fillings or changing them. In short, the system would be broken before it got off the ground unless the system were fixed long in advance of implementation of some sort of universal healthcare.
All the problems that exist now would be worse because AETNA and HUMANA and Kaiser Permanente would demand some sort of bone for giving up what has been lucrative for them. All the suppliers of toxic medical substances, like amalgams, Thimerosal, and even chemotherapeutic drugs would howl bloody you know what if a ding were put in their profits.
So, the only way the system would work is if we reformed our government and economic system, and if it gets much worse, this transformation may be forced on those who are presently resisting. For argument's sake, let's say, we reform and the profit motive is whipped into something reasonable -- or the whole healthcare system becomes patient-owned (and operated?)
This would solve one problem but there would still be the matter of what works. At present, as another example, oncologists who put patients on chemotherapeutic drugs get kick backs, not only in the U.S. but in Germany and other countries as well. The kick backs are significant and I cannot tell you how betrayed patients have felt when they discovered that the reason they had to drive three hours to see a "specialist" was that the specialist was someone not only getting kick backs but sharing the wealth with those who referred patients to him.
A study was done by Dr. Ulrich Abel at Heidelberg University on chemotherapy and the conclusion, after cranking the numbers supplied by hundreds of clinics across Europe, was that only one percent of patients benefited at all from chemotherapy. Did this change anything? The story was reported constantly in Der Spiegel for 18 months but nothing changed. In Italy, which has the highest ratio of doctors to patients anywhere in the world, there is a class action law suit against oncologists for prescribing drugs with such low efficacy and such horrible side effects, not to mention the wasted time and effort and chronic side effects.
So, you see, universal healthcare only relieves the patients' economic hardships. The system itself is not actually improved by the coverage. It's still big business for the people working in the industry and big business for the providers of equipment and pharmaceuticals.
Worse, what I saw was another class issue. Those who had the money usually had private insurance, but it cost a lot, an enormous amount. The moment the patient presented, he or she recited the insurance policy number and up popped the name, address, and entire medical history on a national computer network. In an enormous system, the government or agency managing the insurance has an absolutely amazing database that includes everyone. There are no secrets and the potential for abuse is everywhere. As a professional, I have to admit that I found it very convenient that I could see not only the diagnosis and dates of procedures but even which vitamins and enzymes were prescribed because these are not sold over the counter in Germany. So, let's say a patient had been treated for depression or bipolar disorder, it's not quite a well kept secret. What if the person has a sexually transmitted disease, especially AIDS? Could this affect employment prospects? What if the person is a high profile, entertainer or performer and there was a condition that might require time off, would the person be hired? Beverly Sills died on Monday. Her cancer battle went on for years, but if she had been diagnosed at age 25, it is highly unlikely we ever would have seen her on stage.
As someone in the alternative health area, I see many people who are not necessarily committed to natural approaches to healing; but they are obsessive about their privacy. As many of you know, I was in a law suit with an insurance company over mold. The first thing the insurance company demanded was access to my medical history. I told them I had not seen a doctor since 1970 and the records did not exist. They demanded the records of my clients, bank records, tax returns, copies of emails, etc., etc., etc. They even wanted copies of tapes of psychic readings, anything they might use to discredit me. I did not comply with the requests because the issue was remediation of the house, but the insurance companies will do almost anything to avoid making good on a claim and harassment is one way to wear people down. The judge said "you gave up your right to privacy when you filed the law suit." I was so stunned that I blurted out, "you're kidding!" She fined me $1000. I don't think I was sassy. I was shocked that a court would ask me to break my confidentiality agreement with my clients. It was absolutely unbelievable. My point is simply that unless we fix the system, any person who challenges the system will be subjected to the same sorts of ordeals and the added stress is not good for any patient.
So, our system is totally broken, but if we copy one of the systems in Europe, what will happen when there is a leak? Why are public employees carrying sensitive information around on laptop computers? This happens every single day so the only kind of health care reform that I see as remotely possible in this country would be something that seriously addresses those who are really down on their luck . . . and willing to go the conventional route. That would not include me or 75% of the people in my circle which might be a small pond in comparison to the whole, but this is a minority that is zealous about freedom of choice.
Another point made in SiCKO is that Americans are afraid of their government. This is unfortunately true. It is true in many areas of life, but where healthcare is concerned, stepping over the line has been severely punished. One medical doctor said to me once that he wished they would take away his license so he could do anything he wanted. Two doctors I know became shamans and both were much happier in these roles than in their former work, but it should not be necessary to let the license expire so as to be free to work with people in a more holistic manner. The one who thought losing his license might be a good thing discovered otherwise when the axe fell; he spent hundreds of thousands of dollars on his legal defense and had a jail sentence hanging over his head four 4-5 years. He was acquitted, but the soul of a healer is wounded by these experiences and our society is wrong to limit practices to some norm that was determined decades ago and was probably almost obsolete before it was standarized.
This is a dilemma because modern medicine relies on the mythology of new discoveries, but it restricts the practice of all discoveries that are not profitable to the status quo. If anyone doubts how dangerous a megalithic mindset can be, we only need to look at the debates over stem cell research. While patients are flocking to China for procedures that are not available here, we have to look in the mirror and ask if we like what we see and if we are ready for a major overhaul.
I did not find this megalomania or paranoia in Germany or other countries in Europe. Doctors have much wider latitude in determining how they might manage a case, but they have an odd mixture of lack of availability of natural remedies such as herbs but more access to electronic diagnostic devices, darkfield microscopy, and other tools that are much harder to use here. They are also not as rushed, and they take a lot of vacations, something that absolutely astounded me. We work much harder for much less here!
I plan to write extensively on the details of my concerns. In the meantime, I would urge you to see SiCKO. It will probably make you laugh and cry. The trailers are quite misleading. I found more substance in the less colorful passages, but the heat is bound to go up now and it will surely affect the campaigning for the 2008 election.
